By Sarah Godcher Murphy
Berklee.edu Correspondent
February 7, 2002

Sponsored by the college's Music Therapy Department, the symposium broke new ground by uniting for the first time in an academic setting music-and-cognition scientists with clinical therapists who use music to treat patients. The goal of the symposium was twofold: To bring students up to date on the latest discoveries in music neurology and music therapy, and to develop among neurologists and therapists a shared research agenda. In other words, it was about the sharing of information.

"In establishing a new research agenda for music and neurology with some of the world's leading experts, Berklee is leading the way for important collaborations between neurologists, musicians, and music therapists," said Dr. Suzanne Hanser, chair of the Music Therapy Department.

Participating in the symposium were neurologists from some of Boston's leading medical institutions, including Anne Blood, Ph.D., Department of Neurology, Massachusetts General Hospital; Mark-Jude Tramo, M.D., Ph.D., Department of Neurology, Massachusetts General Hospital; and Gottfried Schlaug, M.D., Department of Neurology, Beth Israel-Deaconess Hospital.

The symposium also included distinguished music therapists Kathleen Howland, Ph.D., MT-BC, who works for the New England Conservatory of Music, and Concetta Tomaino, D.A., MT-BC, director of the Institute for Music and Neurologic Function at Beth Abraham Medical Center in New York.

Drs. Tomaino and Howland drew on many examples from their experiences as music therapists to demonstrate music's healing effects on the brain. Stroke and Alzheimer's disease are two types of neurological dysfunction that respond particularly well to music therapy, they said.

Stroke often can result in diminished control over motor function, including the ability to walk normally. Stroke patients who lose their normal gait have not suffered physical injury to their legs; rather, the area of the brain that controls movement has been damaged. In the brains of such patients, "the internal rhythmic organizing device is shot, but external rhythm will rehabilitate the patient," Dr. Howland said.

-Music therapists have found that the use of a metronome can provide this external rhythm by establishing the tempo of a normal gait. In many cases, patients find that listening to music or humming a song during rehabilitative therapy will help restore the brain's sense of internal rhythm, eventually enabling the patient to walk normally.

Aphasia is another stroke-related disability that can be treated successfully with music therapy. Patients with aphasia lose capacity for normal speech because the areas of their brain that control language were damaged by the stroke. However, many aphasia patients find they are still able to sing, because the music areas of their brains were not affected.

With the help of a therapist, many patients with aphasia can use music to restore normal speech. These patients first learn to sing lyrics accompanied by instrumental music. Then the patients practice singing without accompaniment. Finally, they attempt speaking without the aid of melody. Through this rehabilitative process, approximately 25 percent of patients are able to recover their ability to speak, according to Dr. Tomaino, who hopes that future neurological research will reveal what structures in the brain must remain, post-stroke, for this process to be effective.

Many individuals with Alzheimer's disease also respond positively to music therapy. The presence of a therapist singing popular songs from the patient's childhood can stimulate a range of brain activity in patients with diminished neurological functioning. It also can help to create a sense of familiarity in patients who, because of their disease, can no longer recognize their surroundings.

Music can be particularly effective in mediating the effects of "sundowning" on Alzheimer's patients. Sundowning is a state of increased agitation that occurs around the close of the day, partially in response to diminishing light. Dr. Tomaino believes sundowning is also a response to unmet expectations of familiarity. Many patients associate late afternoon and early evening with coming home from work or having a family dinner, she said. When they find their expectations of familiarity are not being met, the patients act out and can become difficult for their caretakers to manage.

In her work with Alzheimer's patients, Dr. Tomaino has found that playing familiar music in the afternoon, before sundowning normally begins, can help prevent agitation in many patients. Likewise, the repeated singing of a patient's favorite song can help establish a pattern of predictability and can trigger object recognition, memory, and other cognitive function in patients that are otherwise unresponsive to stimuli.

Over the course of their practice, music therapists have made many discoveries into music's ability to affect human behavior and correct neurological dysfunction. But to a large extent, music therapists depend on scientists and medical doctors to conduct new research into music's physical effect on the brain.

Two such scientists, Dr. Gottfried Schlaug and Dr. Mark Tramo, gave students a brief overview of their research during Berklee's symposium. Dr. Schlaug presented his study comparing the brains of professional musicians and non-musicians. Some of the Berklee students in the room were disappointed to learn that, according to Dr. Schlaug, their brains are not significantly larger than their non-musical counterparts. But in some ways they are different.

Dr. Schlaug's data showed that while total brain volume is about the same regardless of musical ability, musicians tend to have larger motor cortexes than non-musicians. Also, years of repetitive practice can lead to the strengthening of existing synapses and even the formation of new ones. And, for reasons not fully understood, there are even more pronounced differences in the brains of musicians with absolute pitch.

	Dr. Gottfried Schlaug makes a point during the panel.
	Photo by Sarah Godcher

Another important area worthy of study is the possible effect of music on psychoimmunology, or how emotional states influence the central nervous and immune systems. Because music has the power to manipulate emotion, it could become an even more powerful tool in the treatment of psychosomatic illnesses. Future research into music's relationship with psychoimmunology could lead to expanded practice of music therapy in the treatment of emotion-related disorders, such as peptic ulcer, irritable bowel, hypertension, muscle pain, asthma, and headache. And as scientists discover more about the link between emotion and the immune system, music could someday be used to strengthen the body's resistance to infection.

Drs. Tramo and Schlaug emphasized that the value of their research lies not only in making discoveries, but in using those discoveries to develop new methods of treatment. Improving the lives of patients was the stated goal for all of those participating in the symposium, be they scientist or therapist. All agreed that collaboration will be essential to reaching that goal, and that Berklee's symposium was an invaluable first step.

Sarah Godcher Murphy is a publicist in the Office of Public Information.